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General Surgery

Answer 4
  1. Prophylactic antibiotics in the postoperative period. It is estimated that 20% of patients undergoing intra-abdominal procedures will develop a surgical site infection, and in elective colorectal resections, this incidence is reported to be as high as 26%.4 To reduce surgical site infection in colorectal surgery, IV antibiotics should be administered preoperatively and as close to the time of incision as possible. In colorectal surgery, E. coli and B. fragilis are the target pathogens. Systemic antibiotics after wound closure have not been shown to reduce surgical site infection rates. Prolonged postoperative administration increases cost, produces resistance, and will cause antibiotic-associated morbidity.5 Each patient must have a thorough and complete mechanical bowel preparation.5 When properly given, oral antibiotics have been shown to reduce surgical site infections.

    4. Smith RL, Bohl JK, McElearney ST, et al. Wound infection after elective colorectal resection. Am Surg 2004;239:599608.

    5. Fry DE. The truth is in the dialogue. Surgical Infection Society-Europe Semmelweis Lecture. Surgical Infection Society-Europe Surg Infect (Larchmt) 2005;6:19-25.

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